Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Introduction: Diffuse idiopathic skeletal hyperostosis (DISH) is a common but frequently underrecognized skeletal disorder, and epidemiological data from Latin America are lacking. This study aimed to estimate the prevalence of DISH and investigate factors associated with the disease in a Brazilian population. Methods In this cross-sectional study, digital chest radiographs (posteroanterior and lateral views) and medical records from a private pulmonology outpatient clinic were reviewed. DISH was diagnosed according to the Resnick and Julkunen criteria. Vertebral fractures and thoracic aortic calcification were assessed using Genant’s semiquantitative method and the classification proposed by Symeonidis et al., respectively. Associations between DISH and demographic and clinical variables were evaluated using Pearson’s chi-square test and multivariable logistic regression analyses. Results A total of 1,005 individuals were included. The prevalence of DISH was 25.9% (n = 260) and 17.3% (n = 174) according to the Julkunen and Resnick criteria, respectively. Interobserver agreement was substantial for the Julkunen criteria (κ = 0.763; 95% CI 0.607–0.862) and almost perfect for the Resnick criteria (κ = 0.879; 95% CI 0.790–0.932). DISH prevalence increased significantly with age, reaching 35.7% and 24.7% among individuals aged ≥ 60 years according to the Julkunen and Resnick criteria, respectively, with no significant sex differences. In multivariable analyses, age ≥ 60 years, diabetes mellitus, and aortic calcification remained independently associated with DISH according to both classification systems. Conclusion DISH was highly prevalent among middle-aged and older adults and was independently associated with aging, diabetes mellitus, and aortic calcification. Recognition of DISH on routine chest radiographs may help identify individuals with an unfavorable cardiometabolic profile.
Source: Research Square
Authors: Felipe Merchan Ferraz Grizzo, Lais Yurie Facimoto, Luciano Henrique Gazoni Scremin, Leandro Hideki Otani, Felipe Cayres Nogueira Rocha Loures, Cassiano Christmann, Gabriel Augusto Lima Mortean, Lorena Lima Gargaro, Willian Augusto Melo, Luciano Andrade, Sanderland José Tavares Gurgel, Gabriel Caetano Pereira, Paulo Roberto Donadio, Natália Pereira Machado, Marcelo Medeiros Pinheiro
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203441369